Attachment 5 - Work Certificate PM_W912PB26QA018.pdf

This is a Work Certificate template for Preventive Maintenance services used to document and authorize equipment maintenance work performed by a contractor.

The certificate serves as an official record of preventive maintenance activities and requires completion of multiple data fields including inventory number, site location, customer information, equipment details (type, manufacturer, model, year of manufacture), and Contract Line Item Number (CLIN). The work section captures the maintenance service period (start and finish dates), assigned technician name, maintenance frequency interval, quantity of services, unit price, and total price in Euros. The form includes dedicated sections for listing materials and maintenance parts used during the service and for documenting the condition of equipment following maintenance completion. A safety inspection label attachment is indicated with yes/no checkboxes. The certificate requires three authorized signatures: customer/client signature with date, technician signature with date, and inspector or Contracting Officer's Representative (COR) signature with date. The total price amount in Euros is displayed prominently at the bottom of the form. This template is designed for bilingual use with parallel German and English terminology throughout.